Provider Demographics
NPI:1598123473
Name:CHULATA-CASTINADO, VERONICA
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:CHULATA-CASTINADO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 574
Mailing Address - Street 2:
Mailing Address - City:LAPORTE
Mailing Address - State:CO
Mailing Address - Zip Code:80535-0574
Mailing Address - Country:US
Mailing Address - Phone:402-641-0681
Mailing Address - Fax:
Practice Address - Street 1:3500 SABRE DR.
Practice Address - Street 2:
Practice Address - City:LAPORTE
Practice Address - State:CO
Practice Address - Zip Code:80535
Practice Address - Country:US
Practice Address - Phone:402-641-0681
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-05
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health